Embolización selectiva como tratamiento de la hemorragia obstétrica

Objective

To describe cases of obstetric hemorrhage that have called for selective intra-arterial embolization and the different embolization techniques used. To assess the clinical outcomes and postprocedural fertility.

Material and methods

We studied 27 women with obstetric hemorrhage. In 24 patients, embolization was performed by catheterizing both uterine arteries and in 2 patients only one uterine artery was catheterized (pseudoaneurysm). The materials used for embolization consisted of Spongostan in 17/27, particles in 9/27, and coils in 1/27. Clinical follow-up included an analysis of early and late complications and of postprocedural fertility.

Results

Hemorrhage was classified as primary (25/27) or secondary (2/27).The cause of bleeding was vaginal delivery (20), cesarean sections (5), abortion (1), and cervical ectopic pregnancy (1).The initial technical success rate was 100% and the clinical success rate was 92.6% (25 of the 27 patients).Bleeding ceased and the outcome was satisfactory in 25 patients. During clinical follow-up ranging from one to seven years, 23 patients had normal menstruation and 6 patients completed 7 full-term pregnancies.

Conclusion

Intra-arterial embolization for obstetric hemorrhage leads to good outcomes and few complications and it preserves fertility.     

Coronariografía mediante tomografía computarizada con sincronización prospectiva. Comparación de la calidad de imagen y dosis de radiación con equipos de 128 detectores de fuente única y doble fuente

Objective

To compare the image quality and radiation dose in a group of patients undergoing coronary CT angiography using a 128-slice dual source helical CT scanner with high pitch alto and prospective acquisition with those in a group of patients with similar clinical characteristics undergoing coronary CT angiography using a 128-slice single-source CT scanner with prospective sequential acquisition.

Material and methods

We included 80 patients with heart rates ≤65 beats/min: 40 underwent sequential 128-slice single source CT with prospective synchronization and the other 40 underwent 128-slice dual source helical CT with high pitch and prospective synchronization. Two radiologists independently assessed the quality of the images of the coronary arteries on the 80 coronary CT angiograms: image quality was classified on a four-point scale in which 1 represented excellent and 4 deficient. The effective dose of radiation was also calculated.

Results

The clinical characteristics of the patients in the two groups were similar. The image quality obtained with dual source CT was significantly better than that obtained with single source CT (P=0.006). The mean effective dose of radiation in the group undergoing dual source CT was 36% lower than in the group undergoing single source CT (1.4±0.6 mSv vs. 2.2±0.9 mSv; P<0.01).

Conclusion

Although both sequential 128-slice single source CT with prospective acquisition and 128-slice dual source helical CT with high pitch and prospective acquisition provide good image quality and low effective doses of radiation, 128-slice dual source helical CT with prospective acquisition provides better image quality and results in a lower effective dose of radiation.     

El síndrome congestivo pélvico. Resultados tras la embolización con espirales

Objective

To study the clinical manifestations and findings at venography in patients with pelvic congestion syndrome and to evaluate the outcome after percutaneous embolization using coils.

Materials and methods

We studied 34 women referred to the vascular radiology unit from the vascular surgery department for clinical suspicion of pelvic congestion syndrome. All patients underwent venography to assess the competence of the ovarian veins and to detect other varicose pelvic veins. When pelvic varicose veins were detected, they were embolized with coils. Clinical outcomes were recorded after reviewing the clinical history and administering a questionnaire over the phone.

Results

In 22 of the 34 patients, signs of pelvic venous insufficiency were found. The symptoms were mainly pelvic and perineal heaviness (20/22) and pelvic pain (18/22). The technical success of venography and embolization was 100%, with three minor complications that did not require hospitalization. Pelvic heaviness improved in 14 patients (in 13 it was completely eliminated). Pain disappeared in 11 patients and was partially alleviated in another 2.

Conclusion

In patients with pelvic congestion syndrome, the embolization of insufficient pelvic veins achieves clinical improvement with short hospital stays and few complications.     

Clasificación y características del cáncer de intervalo en el programa de detección precoz de cáncer de mama en el Principado de Asturias

Objective

To review and classify the interval cancers found in the Principality of Asturias's Breast Cancer Screening Program (PDPCM). A secondary objective was to determine the histological characteristics, size, and stage of the interval cancers at the time of diagnosis.

Material and methods

We included the interval cancers in the PDPCM in the period 2003-2007. Interval cancers were classified according to the breast cancer screening program protocol, with double reading without consensus, without blinding, with arbitration. Mammograms were interpreted by 10 radiologists in the PDPCM.

Results

A total of 33.7% of the interval cancers could not be classified; of the interval cancers that could be classified, 40.67% were labeled true interval cancers, 31.4% were labeled false negatives on screening, 23.7% had minimal signs, and 4.23% were considered occult. A total of 70% of the interval cancers were diagnosed in the year of the period between screening examinations and 71.7% were diagnosed after subsequent screening. A total of 76.9% were invasive ductal carcinomas, 61.1% were stage II when detected, and 78.7% were larger than 10 mm when detected.

Conclusions

The rate of interval cancers and the rate of false negatives in the PDPCM are higher than those recommended in the European guidelines. Interval cancers are diagnosed later than the tumors detected at screening. Studying interval cancers provides significant training for the radiologists in the PDPCM.     

Energía dual y angioTC de carótidas: calidad,eliminación de hueso y dosis de radiación de 80/140 kV frente a 100/140 kV

Objective

To study the differences in vascular image quality, bone subtraction, and dose of radiation of dual energy CT angiography of the supraaortic trunks using different tube voltages.

Material and methods

We reviewed the CT angiograms of the supraaortic trunks in 46 patients acquired with a 128-slice dual source CT scanner using two voltage protocols (80/140 kV and 100/140 kV). The “head bone removal” tool was used for postprocessing. We divided the arteries into 15 segments. In each segment, we evaluated the image quality of the vessels and the effectiveness of bone removal in multiplanar reconstructions (MPR) and in maximum intensity projections (MIP) with each protocol, analyzing the trabecular and cortical bones separately. We also evaluated the dose of radiation received.

Results

Of the 46 patients, 13 were studied using 80/140 kV and 33 with 100/140 kV. There were no significant differences between the two groups in age or sex. Image quality in four segments was better in the group examined with 100/140 kV. Cortical bone removal in MPR and MIP and trabecular bone removal in MIP were also better in the group examined with 100/140 kV. The dose of radiation received was significantly higher in the group examined with 100/140 kV (1.16 mSv with 80/140 kV vs. 1.59 mSv with 100/140 kV).

Conclusion

Using 100/140 kV increases the dose of radiation but improves the quality of the study of arterial segments and bone subtraction.     

Secuencia de disparo único eco de gradiente en fase y fase opuesta con preparación de la magnetización: descripción y optimización de la técnica con equipo de 1,5 T

Purpose

To implement in-phase and out-of-phase (IP/OP) techniques with Magnetization-Prepared Gradient Recalled Echo (MP-GRE) and to evaluate the feasibility and diagnostic image quality among pre and post-optimized MP-GRE sequences, including patients unable to cooperate with breath-hold requirements.

Materials and methods

Institutional review board approval with waiver of informed consent was obtained for this HIPAA-compliant retrospective study. Two groups of patients were included in the study, before and after optimization of MP-GRE parameters, with seventy-three (24 noncooperative/49 cooperative) and sixty-four (22 noncooperative/42 cooperative) consecutive patients, respectively. The motion-insensitive sequence used in this study was a single-shot 2D MP-GRE. Two radiologists qualitatively evaluated the sequences to identify the presence of phase cancellation artifact in OP images and to determine image quality, extent of artifacts (respiratory ghosting, bounce-point artifact, spatial misregistration and pixel graininess) and lesion conspicuity on the various sequences. The ability to visually detect liver steatosis and fatty adrenal adenomas was evaluated. Qualitative analyses were compared using the Wilcoxon and Mann-Whitney tests.

Results

There were statistically significant differences between all MP-GRE sequences concerning phase cancellation artifact (P<.0001) which was present in MP-GRE OP sequences and negligible to absent in the pre (IP₁) and post-optimized (IP₂) MP-GRE IP sequences, respectively, in all patients.Bounce point artifacts were significantly more pronounced in MP-GRE IP₁ (P<.0001). Spatial misregistration was slightly more prominent in noncooperative patients with MP-GRE IP₂ (P=.0027). MP-GRE OP and MP-GRE IP₂ showed significantly higher overall image quality (P<.0001).MP-GRE sequences subjectively identified hepatic steatosis (n=20) and adrenal adenomas (n=5) based on signal loss from IP to OP sequence.

Conclusion

Single shot IP/OP MP-GRE is feasible and allows motion resistant imaging with adequate diagnostic image quality. This technique is able to provide IP and OP information in patients unable to suspend respiration.     

Tratamiento endovascular de estenosis intracraneales sintomáticas: resultados a corto y largo plazo de un único centro

Objectives

We present the short- and long-term results of a series of patients with symptomatic intracranial arterial stenoses treated with angioplasty and stenting.

Material and methods

We reviewed patients with symptomatic intracranial stenoses greater than 50% who were treated with angioplasty, stenting, or both. We recorded demographic data and risk factors (hypertension, diabetes, dyslipemia, ischemic heart disease). We classified all lesions treated according to their location, degree of stenosis, and length. The degree of stenosis was classified as moderate (50%-70%) or severe (>70%). In the follow-up, we assessed cerebrovascular accidents, episodes of ischemic heart disease, and deaths in the first 30 days and in later follow-up.

Results

Between 2006 and 2010, we treated 26 patients (21 men and 5 women; age range, 44-79 years; mean age, 63 years) with 29 intracranial lesions. The endovascular procedure (angioplasty + stenting) was successfully performed in 23 cases (92.0%). In the first 30 days after the procedure, 3 (11.5%) patients had adverse effects of vascular origin: 1 stroke, 1 hemorrhage, and 1 death due to thrombosis of the stent. Long-term follow-up (5-46 months) in the 25 patients who survived more than 30 days detected no recurrence of symptoms.

Conclusion

Endovascular treatment of intracranial stenosis is technically feasible. Short-term complications are highly prevalent. No recurrence of symptoms was detected during long-term follow-up.     

Técnicas de recanalización vertebrobasilar antes de la introducción de las endoprótesis recuperadoras: la reapertura no es sinónimo de buena evolución

Objectives

To evaluate the recanalization rate and clinical outcome three months after endovascular treatment for vertebrobasilar occlusion before the placement of stentrievers.

Material and methods

We reviewed all cases of basilar thrombosis treated with endovascular techniques at our center. We reviewed the clinical outcomes with the main objective of determining the recanalization rate and the secondary objective of evaluating the outcome using the modified Rankin scale (mRS) three months after treatment. We assessed clinical and angiographic variables and correlated them with outcome and complications.

Results

We reviewed a total of 27 consecutive patients (mean age, 58.1 ± 15.5 y; median National Institutes of Health Stroke Scale (NIHSS), 21, interquartile range, 18-29; median Glasgow coma score (GCS) 7, interquartile range, 4-9.5). The mean time between the onset of symptoms and endovascular treatment was 26.3 ± 41.7 hours. Complete or partial recanalization was achieved in 23 (85.1%) patients. Three months after treatment, 16 (59.2%) had died and 6 (22.2%) had good outcome (mRS ≤ 2).

Conclusion

Endovascular treatment achieved a high rate of recanalization of occlusions of the basilar artery. Nevertheless, a high percentage of the patients did not have a good outcome. New materials might improve the prognosis in these patients.     

Resonancia magnética de perfusión en astrocitomas de alto grado: el volumen sanguíneo cerebral,la altura del pico y el porcentaje de recuperación de intensidad de señal ¿pueden discriminar entre progresión y seudoprogresión?

Objectives

To study the usefulness of common MRI perfusion parameters for identifying pseudoprogression in high grade astrocytomas.

Material and methods

This retrospective case-control study compared the relative cerebral blood volume (rCBV), the relative percentage of signal intensity recovery (rPSR), and the relative peak height (rPH) recorded in a sample of 17 cases of anaplastic astrocytomas and gliomas considered to be undergoing pseudoprogression by biopsy or follow-up with those recorded in a sample of histologically similar tumors that were treated and considered to be undergoing progression by histologic study or follow-up. We evaluated the accuracy of these parameters and the correlations among them. Statistical significance was set at P<.05.

Results

The rCBV, rPSR, and rPH were significantly different between the two groups (P=.001). The cutoff values rPH=1.37, rCBV=0.9, and rPSR=99% yielded sensitivity (S)=88% and specificity (Sp)=82.2% for rPH, S=100% and Sp=100% for rCBV, and S=100% and Sp=70.6% for rPSR, respectively. We found negative correlations between rPRS and rPH (−0.76) and between rPRS and rCBV (−0.81) and a high positive correlation between rPH and rCBV (0.87).

Conclusion

The variables rPH and rCBV were useful for differentiating between pseudoprogression and true progression in our sample. The variable rPRS was also very sensitive, although the overlap in the values between samples make it less useful a priori.     

Características en tomografía computarizada de la isquemia cecal aislada

Objective

The aims of this review are to describe the main characteristics for the CT diagnosis of isolated caecal ischaemia (ICA) and give details of the differential diagnosis with other conditions with a similar clinical picture.

Material and methods

A retrospective study was conducted to review the CT findings of 4 patients diagnosed with ICA in our hospital. The parameters recorded to analyse their characteristics in the CT were: maximum thickness of the caecum wall, the appearance of the peri-caecum fat, presence of free fluid, signs of caecal or portal pneumatosis, the appearance of the caecal appendix, and general signs of the presence of vasculopathy.

Results

In all cases it was recorded that there was a thickening of the walls of the blind loop with an abrupt transition between the caecal wall and the walls of the ascending colon wall. In all cases the caecal thickening had a characteristic image in the central area. Signs of caecal pneumatosis were observed in two cases. All of them had an appendix with normal characteristics.

Conclusions

The combination of caecal wall thickening with oedematous characteristics, with no changes in the appendix, ileum and colon, suggest the diagnosis of caecal ischaemia, particularly with the presence of pneumatosis.     

El esquema de biopsia transrectal puede predecir la gradación histológica incorrecta del cáncer de próstata

Objective

To identify factors that might explain why a prostate with a Gleason score (GS) <7 in the biopsy specimen can turn out to have a GS ≥7 in the surgical specimen.

Material and methods

We compared the GS of biopsy specimens with the GS of surgical specimens in 185 patients who underwent surgery for prostate cancer. We calculated the sensitivity, specificity, and predictive values for the GS of the biopsy specimens. We used Cohen's kappa to determine the degree of concordance between a GS of <7 and ≥7 for the biopsy specimen and the surgical specimen. Age, a family history of prostate cancer, total prostate-specific antigen (tPSA), digital rectal examination, prostate structure and volume, and the number of biopsy cores (biopsy scheme) were analyzed using multivariable logistic regression.

Results

Histological study of biopsy specimens yielded high sensitivity (98%) but low specificity (49%) for GS ≤6 and low sensitivity (35, 26%) and high specificity (93, 99%) for GS=7 and GS ≥7, respectively. Cohen's kappa for the GS from the biopsy and surgical specimens was 0.43 (95% CI=30-56%). The biopsy scheme was the only predictor of discordance in the GS between the two techniques. Among the other variables included in the model, only tPSA showed a slightly significant association. Taking a scheme with less than 7 cores as a reference, we found no difference with 8 to 9 cores but we did find a difference with 10 to 11 cores and with 12 or more cores, with a prevalence ratio of 0.138 (95% CI=0.030-0.513) and 0.277 (95% CI=0.091-0.806), respectively.

Conclusion

The GS of the biopsy depends on the scheme. This factor must be taken into account when choosing a treatment option in patients with low tumor grade in biopsy specimens.     

La heterogeneidad del flujo sanguíneo en resonancia magnética,biomarcador para clasificar por grados los astrocitomas cerebrales

Objectives

To study whether the histograms of quantitative parameters of perfusion in MRI obtained from tumor volume and peritumor volume make it possible to grade astrocytomas in vivo.

Material and methods

We included 61 patients with histological diagnoses of grade II, III, or IV astrocytomas who underwent T2*-weighted perfusion MRI after intravenous contrast agent injection. We manually selected the tumor volume and peritumor volume and quantified the following perfusion parameters on a voxel-by-voxel basis: blood volume (BV), blood flow (BF), mean transit time (TTM), transfer constant (K^trans), washout coefficient, interstitial volume, and vascular volume.For each volume, we obtained the corresponding histogram with its mean, standard deviation, and kurtosis (using the standard deviation and kurtosis as measures of heterogeneity) and we compared the differences in each parameter between different grades of tumor. We also calculated the mean and standard deviation of the highest 10% of values. Finally, we performed a multiparametric discriminant analysis to improve the classification.

Results

For tumor volume, we found statistically significant differences among the three grades of tumor for the means and standard deviations of BV, BF, and K^trans, both for the entire distribution and for the highest 10% of values. For the peritumor volume, we found no significant differences for any parameters. The discriminant analysis improved the classification slightly.

Conclusions

The quantification of the volume parameters of the entire region of the tumor with BV, BF, and K^trans is useful for grading astrocytomas. The heterogeneity represented by the standard deviation of BF is the most reliable diagnostic parameter for distinguishing between low grade and high grade lesions.     

La technique de Didier Patte dans les luxations récidivantes de l’épaule : notre expérience à propos de 35 cas avec un suivi d’une dizaine d’années

Aims

Authors report their personal experience on the surgical treatment of repeated anterior shoulder dislocations, using an anterior bone block in accordance with the procedure suggested by Didier Patte.

Results

From the year 1988 and during 10 years, 35 patients suffering from repeated anterior shoulder dislocations were surgically treated by this procedure. It was appropriate to retrospectively review the clinical and functional outcomes after Patte repair for recurrent anterior glenohumeral instability. The mean follow-up was approximately 10 years, with a mean percentage of 75% for the observance. There was no recurrence after surgery. Moreover, 88% of patients had good outcomes, according to the scale suggested by Butel et al., with total resumption of work and physical activities. The occurrence of chronic complication such as osteoathrosis was scarce (only one case for the series), while 20% of subjects showed apprehension during some specific shoulder movements.

Conclusion

In order to expect best functional outcomes, the choice of the surgical procedure should take into account the extent of initial injury. Considering these ground requirements, the Patte procedure seems to provide very satisfactory long-term functional outcomes.     

Contribution à l’étude des effets d’un programme de réentraînement à l’effort sur les aptitudes physiques de patients atteints de bronchopneumopathie chronique obstructive

Aims

The purpose of this study was to evaluate the effect of a three-months’ training rehabilitation on the physical capacity of patients suffering from chronic obstructive pulmonary disease (COPD).

Methods

The aerobic and anaereobic capacity was evaluated in 36 patients (Stage 2) before and after a training rehabilitation period: (duration: three months, frequency: two sessions per week, intensity: 65% of aerobic threshold for 25 min, type: regular exercise on a bicycle).

Results

Training rehabilitation caused a statistically significant specific improvement of submaximal aerobic capacity and an increase of quadriceps and flexor of the fingers’ strength.     

Disfunción del tendón tibial posterior: ¿qué otras estructuras están implicadas en el desarrollo del pie plano adquirido del adulto?

Objective

To evaluate the association of posterior tibial tendon dysfunction and lesions of diverse ankle structures diagnosed at MRI with radiologic signs of flat foot.

Material and methods

We retrospectively compared 29 patients that had posterior tibial tendon dysfunction (all 29 studied with MRI and 21 also studied with weight-bearing plain-film X-rays) with a control group of 28 patients randomly selected from among all patients who underwent MRI and weight-bearing plain-film X-rays for other ankle problems.In the MRI studies, we analyzed whether a calcaneal spur, talar beak, plantar fasciitis, calcaneal bone edema, Achilles’ tendinopathy, spring ligament injury, tarsal sinus disease, and tarsal coalition were present. In the weight-bearing plain-film X-rays, we analyzed the angle of Costa-Bertani and radiologic signs of flat foot. To analyze the differences between groups, we used Fisher's exact test for the MRI findings and for the presence of flat foot and analysis of variance for the angle of Costa-Bertani.

Results

Calcaneal spurs, talar beaks, tarsal sinus disease, and spring ligament injury were significantly more common in the group with posterior tibial tendon dysfunction (P<.05). Radiologic signs of flat foot and anomalous values for the angle of Costa-Bertani were also significantly more common in the group with posterior tibial tendon dysfunction (P<.001).

Conclusion

We corroborate the association between posterior tibial tendon dysfunction and lesions to the structures analyzed and radiologic signs of flat foot. Knowledge of this association can be useful in reaching an accurate diagnosis.     

TIPS recubierto en niños. Estudio preliminar sobre su seguridad y permeabilidad

Objective

To retrospectively analyze the safety and efficacy of transjugular intrahepatic portosystemic shunting (TIPS) using covered stents in children.

Material and methods

We present 6 children (mean age, 10.6 years; mean weight, 33.5 kg) who underwent TIPS with 8 mm diameter Viatorr^® covered stents for acute (n=4) or recurrent (n=2) upper digestive bleeding that could not be controlled by endoscopic measures. Five of the children had cirrhosis and the other had portal vein thrombosis with cavernous transformation. We analyzed the relapse of upper digestive bleeding, the complications that appeared, and the patency of the TIPS shunt on sequential Doppler ultrasonography or until transplantation.

Results

A single stent was implanted in a single session in each child; none of the children died. The mean transhepatic gradient decreased from 16 mmHg (range: 12-21 mmHg) before the procedure to 9 mmHg (range: 1-15 mmHg) after TIPS.One patient developed mild encephalopathy, and the girl who had portal vein thrombosis with cavernous transformation developed an acute occlusion of the TIPS that resolved after the implantation of a coaxial stent.Three children received transplants (7, 9, and 10 months after the procedure, respectively), and the patency of the TIPS was confirmed at transplantation. In the three remaining children, patency was confirmed with Doppler ultrasonography 1, 3, and 5 months after implantation. None of the children had new episodes of upper digestive bleeding during follow-up after implantation (mean: 8.1 months).

Conclusion

Our results indicate that TIPS with 8 mm diameter Viatorr^® covered stents can be safe and efficacious for the treatment of upper digestive bleeding due to gastroesophageal varices in cirrhotic children; our findings need to be corroborated in larger series.     

Effet d’une hyperventilation volontaire préexercice sur la performance lors de l’épreuve de Wingate

Aim

To determine the effect of a preexercise hyperventilation (HV) on performance measured during the Wingate test.

Protocol

Seven subjects realized the Wingate test whether in normal condition or after the realization of six maximal respiration cycles realized in 30 s. Gas exchanges were recorded breath by breath throughout the test.

Results

Pic power measured during the test was not significantly different after HV. In opposite, the fatigability index (FI) was significantly higher after HV.

Conclusion

A HV does not affect maximal power, but seems to reduce aerobic contribution, which may explain the higher FI observed after HV.     

Factors affecting patients’ satisfaction in nuclear medicine department in Egypt

Background

Nuclear medicine is one of the most dynamic areas of medicine with continual technological innovations and developments of new radiotracers. Patient care is an important duty of any health care personnel. Measuring patient satisfaction is considered as a key dimension of health care quality.The purpose of this study is to assess quality of care and patients’ satisfaction in the nuclear medicine department at Al-Ahrare Hospital-Zagazig, Egypt.

Subjects and methods

A cross sectional study was performed at the nuclear medicine department to measure patients’ satisfaction to the service introduced at the hospital. Questionnaire was adapted from National Health Service of the UK and was used to evaluate patients’ satisfaction during attendance to the department.

Results

It was found that the gender and level of the education of the studied sample were statistically significant (P value < 0.05) affect their general satisfaction of the nuclear medicine department & recommendation the department to the others. Also questions about the informed waiting time, information before examination, noise in department, cleanliness of the department, waiting time to appointment and conflict of information were taken the highest percentage in the patients’ dissatisfaction.

Conclusions

Patients’ satisfaction was high in perceiving the infrastructure of the department while waiting time and giving information before examination were the least satisfied to the patients.     

Preoperative mapping of arterial spinal supply using 3.0-T MR angiography with an intravasal contrast medium and high-spatial-resolution steady-state

Introduction

Preoperative mapping of the arterial spinal supply prior to thoracoabdominal aortic aneurysm repair is highly relevant because of high risk for postoperative ischemic spinal cord injuries such as paraparesis or paraplegia.

Methods

Twenty-four consecutive patients prior to surgical thoracoabdominal aortic aneurysm repair were investigated. All patients underwent steady-state MR angiography (MRA) of the spinal vasculature with 3-T MRI. The sequence used was a steady-state coronary 3D FLASH with 0.7-mm isotropic voxels. MRA was performed using an intravasal contrast agent. Studies were evaluated by three readers including delineation of arterial spinal supply including both aortic origin and spinal canal entry by three readers.

Results

Identification and localization of the Adamkiewicz artery and its spinal canal entry was successful in all patients. Overall depiction of the vascular anatomy was graded as very good in 3 (12.5%), good in 14 (58.4%), sufficient in 5 (20.8%), and poor in 2 (8.3%) patients. Depiction of segmental artery aortic exit level was graded as good in 6 (25.0%), sufficient in 10 (41.7%), poor in 4 (16.7%) and not identifiable in 4 (16.7%) patients. Delineation of segmental artery entry level into the spinal canal was graded as very good in 4 (16.7%), good in 11 (45.8%), sufficient in 6 (25.0%), and poor in 3 (12.5%) patients.

Conclusions

The use of 3-T MRA with an intravascular contrast agent and steady-state enables AKA localization including its segmental arteries with regard to the level of aortic origin and spinal canal entry in most patients.     

Validité et reproductibilité d’un dynamomètre inertiel basé sur l’accélérométrie

Introduction

The purpose of this study was to investigate the validity and reliability of an inertial dynamometer using accelerometry.

Methods

Fourteen subjects were tested during three successive sessions at four increasing loads (30, 50, 70 and 95% of the 1RM). Maximal force, velocity and power performances were simultaneously assessed by the Myotest (Myotest S.A., Switzerland), an inertial dynamometer using accelerometry, and by another control valid dynamometer witch combine accelerometer and linear position transducer. At three first loads, only minor differences appeared in between both dynamometers, correlations were excellent and coefficients of variation were good and similar. However, at 95% of the 1RM, Myotest validity and reliability became insufficient.

Conclusion

Bench press inertial assessment with accelerometer appeared valid and reliable at 30, 50 and 70% of the 1RM, but not at 95% of the 1RM.